title: Delayed diagnosed stage 1, 2 distractive flexion injury of the cervical spine.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To examine the clinical and radiologic characteristics of patients with stage 1 and 2 distractive flexion injury according to Allen's classification and who were not diagnosed immediately after injury, and to analyze the outcomes of surgical treatments.
  
  
  BACKGROUND
  For the diagnosis of stage 1 and 2 distractive flexion injury in the lower cervical spine, attention should be paid when performing radiographs as well as when interpreting the radiographs.
  
  
  METHODS
  The study was conducted on 10 patients (group 1) with stage 1 or 2 distractive flexion injury and who were not diagnosed immediately after injury from January 2003 to January 2009. The control group (group 2), 16 distractive flexion injury patients who were diagnosed immediately were selected. The simple radiographs, the degree of soft tissue swelling and the magnetic resonance imaging findings of the two groups were compared, and the clinical and radiologic results were examined.
  
  
  RESULTS
  The degree of the prevertebral soft tissue swelling of group 1 was lower in group 1, and it was statistically significant (p = 0.046). The fusion was achieved in all cases (100%) in group 1, however, re-displacement as well as the loss of reduction occurred in one case, despite of delayed fusion and good clinical result. In group 2, bone fusion was achieved in 15 cases of 16 cases (94%).
  
  
  CONCLUSIONS
  For the diagnosis of stage 1 and 2 distractive flexion injury in the lower cervical spine, it is desirable to perform computed tomography if diagnosis is not clear. Even if the diagnosis is delayed, stage 1 and 2 distractive flexion injury could be readily reduced by traction, and the treatment outcomes are considered to be comparable to those of the patients diagnosed immediately after injury.
authors.affiliation: Spine Center, Haeundae Paik Hospital, Inje University, Busan, Korea.
authors.forename: Taek-Soo
authors.initials: TS
authors.lastname: Jeon
authors.forename: Han
authors.initials: H
authors.lastname: Chang
authors.forename: Young-Bok
authors.initials: YB
authors.lastname: Kim
authors.forename: Byung-Hak
authors.initials: BH
authors.lastname: Oh
authors.forename: Sang-Bum
authors.initials: SB
authors.lastname: Kim
authors.forename: Tae-Seok
authors.initials: TS
authors.lastname: Nam
authors.forename: Ji-Wan
authors.initials: JW
authors.lastname: Kim
authors.forename: Kun-Bo
authors.initials: KB
authors.lastname: Park
authors.forename: Hyun-Wook
authors.initials: HW
authors.lastname: Chung